Medicine in a Minute

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In the absence of total thrombotic occlusion, an NSTEMI or unstable angina may commonly develop, and ECG changes (such as ST segment depression and/or T wave inversion) may occur Clinical features: Refers to the load exerted on a muscle after the onset of contraction (e.g. systolic pressure), which must be overcome before the muscle begins to shorten

Myocardial wall motion is used as a surrogate marker for perfusion, because ultrasound cannot visualise blood flow in the arteries Superior to echocardiography in visualising structure and function; not limited by body habitus (physique) The heart consumes more oxygen per tissue mass than any other organ in the body: myocardial blood supply occurs via the right and left coronary arteries, which arise as the first branches of the aorta at the right and left sinuses of Valsalva, respectively Medicine in a Minute is a new full-colour text covering the fundamentals of undergraduate medicine in one book. Medical students no longer have the time or inclination to read the huge texts that used to dominate this market – they need a concise book that covers the core information they have to know, and in a user-friendly format: Medicine in a Minute is this book! GTN: may be given via the sublingual or buccal route – if minimal to no response, an IV infusion may be considered; note that GTN should be avoided if systolic BP <90mmHgThis sentence still holds today. We know that every substance, especially drugs, may be toxic if given in an inappropriate dose. An example of a well known but potentially toxic substance is Tylenol ( paracetamol). This is why we should perform our dosage calculations carefully and accurately. This is especially critical when administering drugs to children, as a slight mistake in the dose may cause a significant change in the effect of its action. The usage of a pediatric dose calculator seems to be a responsible choice that reduces the risk of a mistake! Ventricular tachycardia and ventricular fibrillation may result in sudden death in up to one-fifth of patients May be clinically silent or the patient may experience pleuritic chest pain that classically improves on sitting up The SA nodal artery is supplied by the RCA in two-thirds of the population, and by the LCX in one-third Angiotensin-converting enzyme (ACE) then converts angiotensin I into angiotensin II, which mediates its effects, primarily by vasoconstriction and increased water retention. The jugular venous pressure (JVP)

ABPM: at least 2 readings per hour every waking hour, with an average of 14 readings required for diagnosisMedicine in a Minute is a new full-colour text covering the fundamentals of undergraduate medicine in one book. Medical students no longer have the time or inclination to read the huge texts that used to dominate this market - they need a concise book that covers the core information they have to know, and in a user-friendly format: Medicine in a Minute is this book! BP is also monitored during the test; a sustained decrease in BP may also suggest coronary artery disease Bivalirudin (direct thrombin inhibitor), in combination with aspirin and clopidogrel, is recommended for patients with STEMI undergoing PPCI (although practice may vary between centres)

The ATP III Guidelines are also a useful accessory when evaluating lipid-lowering therapy in ischaemic heart disease. Patients are stratified according to their 10-year risk, with >20% risk being a coronary heart disease equivalent; ≤20% conferring moderate risk; and patients with 0–1 risk factor (or a lower than 10% 10-year risk score by default) being regarded as low risk. Target LDL levels are thus recommended, using a fasting lipid panel: Medical students no longer have the time or inclination to read the huge texts that used to dominate this market – they need a concise book that covers the core information they have to know, and in a user-friendly format: Medicine in a Minute is this book. The book is edited and written by two of the authors behind the bestselling Cardiology in a Heartbeat and features several common design elements and features. Risk calculators, such as QRISK3 or Framingham, are useful for doctors to predict a patient’s risk of developing a CVD within a 10-year period. However, these risk assessment tools are not recommended for use with patients who are type 1 diabetics or those with pre-existing cardiovascular disease.General principles: the aim of management is to ensure treatment of all underlying pathology, encourage lifestyle changes (including treating sleep apnoea, which has been linked to poorer outcomes), manage symptoms and prevent episodes of acute decompensation as far as possible. Weighing the patient daily may also help provide an assessment of fluid status.

The joint ESC/ACCF/AHA/WHF task force published the following recommendations for the diagnosis of acute MI in 2012.Mechanical compensatory mechanisms include Frank–Starling forces (stretch on myocardial fibres increases subsequent stroke volume) Cardiac myocytes, which differ in cellular structure from skeletal and smooth muscle myocytes, contract at a cellular level by means of a phenomenon known as calcium-induced calcium release. Offer atorvastatin 20mg for primary prevention if estimated 10-year cardiovascular risk using QRISK3 is >10% (note that this is still controversial in some centres) Stress testing is contraindicated if patients have had a recent MI, have severe valvular disease or arrhythmias. The test should be stopped immediately if the patient experiences cardiac symptoms, light-headedness, arrhythmias, >1mm ST elevation or a >10mmHg fall in BP. This in turn activates calcium-sensitive calcium release channels (also known as ryanodine receptors) in the sarcoplasmic reticulum, which causes sufficient flooding of calcium ions to initiate contraction